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A Matter of Semantics

© Adelle Vancil Tilton

Shakespeare once said, "A rose by any other name, would smell as sweet". Now Lily Pharmaceuticals is trying to tell the American public that Prozac by any other name, would smell as sweet. Or sweeter, perhaps in the profit margin. However, that smell, could be dangerous or even deadly, especially if you don't know that it is Prozac you are taking. In the least it is deceptive and an issue of medical ethics.

Now suppose you are one of those absolutely opposed to taking Prozac. But with that terrible PMS problem, and it is a serious problem that is only now being recognized, you wouldn't hesitate at all to take the new medication, especially made to treat PMS. A medication called Sarafem. It is indicated for the "treatment of premenstrual dysphoric disorder (PMDD), which is characterized by severe mood and physical symptoms around a woman's menstrual cycle". Lily Pharmaceuticals is thrilled they have a medication indicated for the treatment of this problem and have issued a press release about it. But read it carefully. They do, although glossing over it to an extent, admit it is Prozac, by saying that it has the same active ingredient found in Prozac. But what they don't say, is that it is the same exact drug.

Under the theory that a rose is a rose is a rose, consider aspirin. We all are pretty much aware that Bayer, generic aspirin, and other brands of aspirin are still aspirin. But when we get into prescriptions, the lines become a little fuzzy. And consider the patient with more than one physician, for example a primary care physician and a gynecologist, which is very common in women. And further consider the likelihood of using different pharmacies. Very likely, considering the hours of one may be more convenient, or in the grocery store, where it is so easy to drop off a new prescription while shopping. Does pharmacy A and pharmacy B know everything you are taking? Probably not. It is easy to forget. And we are supposed to trust our doctors to tell them. A possible scenario from this semantics game the FDA is playing with Prozac is that the primary care physician may prescribe Prozac to a patient for depression. And then the gynecologist, totally unaware of the Prozac, may prescribe Sarafem to the same patient for the PMS disorder. And then we have a patient on a double dose of Prozac. And that can be dangerous. It mostly likely is dangerous. It could be a fatal mistake.

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